Laryngeal cancer: symptoms and causes

Laryngeal cancer is a type of throat cancer which affects the voice box (larynx), which is in the throat.

What is laryngeal cancer?

Laryngeal cancer is a type of throat cancer that affects the voice box (larynx).
The voice box is part of the throat found at the entrance to the windpipe.
Laryngeal cancer is more common in men over the age of 40.
How serious laryngeal cancer is depends on where it is in the larynx, how big it is, if it has spread and your general health.

Laryngeal cancer is a type of throat cancer. There are other throat cancers, including nasopharyngeal, oropharyngeal and hypopharyngeal.

Symptoms of laryngeal cancer

Main symptoms of laryngeal cancer

Symptoms of laryngeal cancer vary depending on where in the voice box (larynx) the cancer is.

The most common symptoms include:

a hoarse voice or change in your voice that does not go away
a lump or swelling in your neck
pain when swallowing or difficulty swallowing
shortness of breath or difficulty breathing

Other less common symptoms include:

an earache that does not go away
bad breath
losing weight without trying

See a GP if:

you have a hoarse voice or change in your voice that does not go away
you have a lump or swelling in your throat – including a lump that has been checked before but is getting bigger
pain or difficulty swallowing

Call 112 or go to A&E immediately if:

you have severe difficulty breathing – you're gasping, choking or not able to get words out

Do not drive to A&E. Ask someone to drive you or call 112 and ask for an ambulance.

Bring any medicines you take with you.

Important

These symptoms are very common and can be caused by other conditions.

Having the symptoms does not definitely mean you have laryngeal cancer, but it's important to get checked by a GP.

If your symptoms are caused by cancer, finding it early may mean it's easier to treat.

What happens at the GP appointment

The GP may look inside your mouth and feel your neck. They may also listen to your chest and tummy to check if they sound normal. They may ask if anyone in your family has had laryngeal cancer.

They might arrange for you to have a blood test or a chest X-ray.

Referral to a specialist

The GP may refer you straight to the ear, nose and throat (ENT) department of your local hospital for more tests.

This may be an urgent referral if the GP thinks you have symptoms that could be cancer. This does not definitely mean you have cancer.

Causes of laryngeal cancer

Who is more likely to get laryngeal cancer?

It's not always clear what causes laryngeal cancer.

Anyone can get laryngeal cancer, but you might be more at risk if you:

are over the age of 40
are a man, especially if you are Black
have a brother, sister, parent or child who has had laryngeal cancer
have certain conditions, such as acid reflux or gastro-oesophageal reflux disease, or have had radiotherapy treatment to your neck

Many laryngeal cancers are linked to lifestyle. For example, you're more likely to get it if you smoke or drink too much alcohol.

How to reduce your chance of getting laryngeal cancer

You cannot always prevent laryngeal cancer. But making healthy changes can lower your chances of getting it.

Do

try to cut down on alcohol – avoid drinking more than 14 units a week
try to quit smoking

It's important to get any symptoms of laryngeal cancer checked by a GP.

Anyone can get laryngeal cancer, even if you do not think you have a high chance of getting it.

Tests and next steps for laryngeal cancer

Main tests for laryngeal cancer

If the GP or specialist thinks you might have laryngeal cancer, they will refer you for tests to look inside your throat.

The main tests for laryngeal cancer include:

looking inside your nose, throat and mouth using a thin tube with a camera in it
looking inside your throat at your voice box (larynx) using a thin tube with a camera in it – they may also remove a sample of cells from your voice box (called a biopsy)
checking any lumps on your neck using a needle and syringe to take a sample

Getting your results

It can take several weeks to get the results of your tests.

You may be asked to go to the hospital to get your results, or they may be sent to you in the post.

Try not to worry if your results are taking a long time to get to you. It does not definitely mean anything is wrong.

You can call the hospital or GP if you're worried. They should be able to update you.

A specialist will explain what the results mean and what will happen next. You may want to bring someone with you for support.

If you're told you have laryngeal cancer

Being told you have laryngeal cancer can feel overwhelming. You may be feeling anxious about what will happen next.

It can help to bring someone with you to any appointments you have.

A group of specialists will look after you throughout your diagnosis, treatment and beyond.

This will include a clinical nurse specialist, who will be your main point of contact during and after treatment.

You can ask them any questions you have.

Macmillan Cancer Support has a free helpline that's open every day from 8am to 8pm.

They're there to listen if you have anything you want to talk about.

Call 0808 808 00 00

Next steps

If you've been told you have laryngeal cancer, you’ll usually need more tests.

You may need:

scans, like a CT scan, MRI scan, ultrasound scan and PET scan
a vocal cord check using a small video camera to see how they move when you speak
a test to look at your nose, throat and upper part of your food pipe under local anaesthetic

You may not have all these tests.

These, along with other tests you've had, will help the specialists find out the size of the cancer and how far it's spread (called the stage).

The specialists will use the results of these tests and work with you to decide the best treatment plan for you.

Treatment for laryngeal cancer

Main treatments for laryngeal cancer

Laryngeal cancer is often treatable.

The treatment you have will depend on:

the size and type of laryngeal cancer you have
where it is
if it has spread
your general health

It may include surgery, chemotherapy, radiotherapy, or targeted medicines and immunotherapy.

The specialist care team looking after you will:

explain the treatments, benefits and side effects
work with you to create a treatment plan that is best for you
help you manage any side effects, including changes to your diet

You'll have regular check-ups during and after any treatments. You may also have tests and scans.

If you have any symptoms or side effects that you're worried about, talk to your specialists. You do not need to wait for your next check-up.

Surgery

Surgery is the often the main treatment for laryngeal cancer, especially if the cancer is found early.

There are several types of surgery used to treat laryngeal cancer, depending on how far it has spread.

Surgery might include removing all or part of your voice box or using a laser to remove the cancer.

You may need to have some lymph nodes removed, these are small glands which are part of the body's immune system.

If you have part or all of your larynx removed recovery can take a long time. You may need a hole in your neck called a stoma, which you will breathe through.

You'll be supported through surgery and recovery by your specialist treatment team. You'll have support to help you speak or communicate after surgery.

Chemotherapy

Chemotherapy uses medicines to kill cancer cells.

You may have chemotherapy for laryngeal cancer:

with radiotherapy (chemoradiotherapy) as the main treatment for your laryngeal cancer
before surgery to help make the cancer smaller
after surgery (usually with radiotherapy) to help stop the cancer coming back
if you are unable to have surgery
if the cancer is advanced, has come back or has spread to other parts of your body

Radiotherapy

Radiotherapy uses high-energy rays of radiation to kill cancer cells.

You may have radiotherapy for laryngeal cancer:

to treat early cancer, usually with chemotherapy (chemoradiotherapy)
to help control and improve the symptoms of advanced cancer

Targeted medicines and immunotherapy

Targeted medicines and immunotherapy aim to stop the cancer growing and help your immune system attack the cancer.

You might have treatment with targeted medicines or immunotherapy:

if the cancer has spread to another part of the body
if the cancer cannot be cured
to lower the risk of the cancer coming back after surgery

What happens if you've been told your cancer cannot be cured

If you've been diagnosed with advanced laryngeal cancer, it may be hard to treat and not possible to cure.

The aim of treatment will be to slow down the growth and spread of the cancer, to help with the symptoms, and help you live longer.

Finding out cancer cannot be cured can be very hard news to take in.

You'll be referred to a team of doctors and nurses called a symptom control team or palliative care team.

They will help you to manage your symptoms and make you feel more comfortable.

The palliative care team can also help you and your loved ones get any other support you need.

Laryngeal cancer